Progressive ophthalmoplegia associated with asymptomatic primary biliary cirrhosis. Histologic, histochemical, cytochemical, and ultrastructural studies of muscle and liver biopsy specimens.

The authors report a case of progressive ophthalmoplegia associated with asymptomatic primary biliary cirrhosis diagnosed by the finding of antimitochondrial antibodies and liver biopsy. Electron microscopic findings showed mitochondrial abnormalities, especially intramitochondrial paracrystalline inclusions, not only in skeletal muscle but also in hepatocytes. Enzymatic digestion revealed the acidic protein nature of the intramitochondrial paracrystalline inclusions of the hepatocyte. To the authors' best knowledge, the association of progressive ophthalmoplegia and primary biliary cirrhosis has not yet been reported in the literature. Despite the mitochondrial abnormalities in both skeletal muscle and liver and the presence of serum antimitochondrial antibodies, no apparent connection between these two diseases was found.

[Peptic esophageal strictures. Dilatation with the Eder-Puestow's olives system (author's transl)]. / Sténoses peptiques de l'oesophage. Traitement par le dilatateur d'Eder-Puestow.

Esophageal dilatations under topical pharyngeal anesthesia with the Eder-Puestow's metallic olives system were performed 101 times on 30 patients presenting peptic strictures. This method uses first a metallic wire introduced into the esophagus and the stomach under endoscopic control. Then, the wire allows to guide dilatating olives through very tight strictures. Functional results were excellent 28 times out of 30; two patients only required repeated dilatations because of uncomplete treatment (stenosis on esojejunal anastomosis). Finally, surgical procedure was never indicated. The use of Eder-Puestow's material together with fiberoptic esophagoscope reduces the hazard of peroral bougienage: no complication occured in our series.

[Comparison between gastric radiology and fiber endoscopy (author's transl)]. / La radiologie gastrique confrontée avec la fibro-endoscopie. Enseignements et déductions pratiques

This paper summarizes the experience from 1969 to 1972 of a mixed team of radiologists and endoscopists at the Northern Marseilles University Hospital Centre. The patients were unselected and the team were not given all the information. After recalling the clinical and radiological conditions, together with the endoscopic conditions of the examination, the authors define the criteria which they chose to orient patients towards fiber endoscopy, i.e. either frankly abnormal radiology, or a radiological examination classed as normal in 563 cases, but which the team considered doubtful. They then report their results. Under these conditions, the results seem to be less unfavourable for radiology than would have been thought, for only 7% of the results were made by endoscopy alone (96 cases out of 1,500). In both benign and malignant ulcer, fiber endoscopy simply confirmed the radiological diagnosis and, in 54% of all the examinations, fiber endoscopy confirmed the normal character of radiology. However, in deciding whether carcinoma or benign ulcer, i.e. 11% of the cases of carcinoma and 14% of the cases of benign ulcer, radiology completely omitted the diagnosis of the lesion which might seem unacceptable. They conclude by asking radiologists to improve their technique of lesion detection and concentrate their examination on the smallest visible lesion in areas considered diffcult to explore radiologically. They are more and more circumspect about giving a full etiological diagnosis of lesions by radiology, especially in gastric ulceration where fiber endoscopy and direct biopsy seems more and more advisable.

Enzyme histochemical study of fat absorption in human duodenal mucosa.

In seven healthy subjects the activities of various intestinal enzymes were studied using a fasting control peroral biopsy and two other biopsies 15 minutes and 30 minutes after an intestinal infusion of emulsified corn oil. Specific histochemical methods permitted the comparison of the enzymatic activities of the absorptive cells at the top of the villi before and during fat absorption which was demonstrated with a Sudan black stain. FOUR OXYDATIVE ENZYMES WERE MODIFIED AFTER THE CORN OIL INFUSION: NADH2-tetrazolium reductase, NADPH2-tetrazolium reductase, glucose-6-phosphate dehydrogenase, and lactate dehydrogenase. In six cases, the activity of NADH2-tetrazolium reductase was increased. Two of these subjects presented a simultaneous increase of NADPH2-tetrazolium reductase and glucose-6-phosphate dehydrogenase. Two other subjects presented a decrease in lactate dehydrogenase activity.